VA Boston Healthcare System, Boston, Massachusetts 02130-4893, USA.
J Pain. 2013 May;14(5):475-82. doi: 10.1016/j.jpain.2012.12.013. Epub 2013 Feb 26.
The purpose of the present pilot study was to assess the efficacy of cognitive-behavioral therapy (CBT) for painful diabetic peripheral neuropathy. This was a randomized, treatment as usual (TAU), controlled, nonblinded intervention pilot study with a 4-month follow-up conducted in a VA medical center. It was hypothesized that participants who received CBT, as compared to those who received TAU, would report significant decreases on self-report measures of pain severity, interference, and depressive symptoms from pretreatment to 4-month follow-up. Participants meeting inclusion criteria were randomly assigned to 1 of the study conditions. Of the 20 eligible participants, 12 were randomized to CBT and 8 were randomized to TAU. Participants randomized to CBT showed significant decreases on measures of pain severity (B = -.54) and pain interference (B = -.77) from pretreatment to 4-month follow-up. There were no significant changes in the TAU participants' scores on measures of pain severity (B = .00) or pain interference (B = -.09). Neither CBT nor TAU participants showed significant changes in their levels of depressive symptoms from pretreatment to 4-month follow-up. CBT may be an effective treatment approach for reducing pain severity and interference associated with painful diabetic peripheral neuropathy.
The results of this study suggest that engaging patients in CBT for painful diabetic peripheral neuropathy may provide them the skills to become more active and experience less pain.
本研究旨在评估认知行为疗法(CBT)治疗糖尿病性周围神经痛的疗效。这是一项在退伍军人事务医疗中心进行的、为期 4 个月随访的、随机、治疗常规(TAU)对照、非盲干预性研究。假设与接受 TAU 治疗的患者相比,接受 CBT 治疗的患者在治疗前和 4 个月随访时,自我报告的疼痛严重程度、干扰和抑郁症状会显著降低。符合纳入标准的参与者被随机分配到研究条件之一。在 20 名符合条件的参与者中,12 名被随机分配到 CBT,8 名被随机分配到 TAU。随机分配到 CBT 的参与者在疼痛严重程度(B=-.54)和疼痛干扰(B=-.77)方面的测量值从治疗前到 4 个月随访时显著降低。TAU 组参与者的疼痛严重程度(B=.00)和疼痛干扰(B=-.09)评分没有显著变化。无论是 CBT 组还是 TAU 组,在治疗前到 4 个月随访时,抑郁症状的水平都没有显著变化。CBT 可能是治疗糖尿病性周围神经痛相关疼痛严重程度和干扰的有效方法。
这项研究的结果表明,让患者参与 CBT 治疗糖尿病性周围神经痛可能会为他们提供更积极、疼痛更少的技能。